File Name: obstetrics and gynecology history taking and physical examination .zip
A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes.
Gynecological history taking involves a series of methodical questioning of a gynecological patient with the aim of developing a diagnosis or a differential diagnosis on which further management of the patient can be arranged. This further treatment may involve examination of the patient, further investigative testing or treatment of a diagnosed condition. There is a basic structure for all gynecological histories but this can differ slightly depending on the presenting complaint. When taking any history in medicine it is essential to understand what the presenting complaint means and what the possible causes differential diagnosis of the presenting complaint may be. After all, it is the aetiology of a symptom that guides the physician's questioning.
When a patient comes to a physician for the first time he places on him a heavy responsibility; under certain conditions the heaviest a human being is called on to bear. Two questions, implied or expressed, must be answered if the patient is to be repaid for his confidence and outlay: What ails me? What must I do to be cured? The conscientious physician looks on these questions as a challenge which can be met only by a true diagnosis and clear-cut, helpful advice. Such a diagnosis is a problem in logic, no less rigorous and exacting than a problem in any of the natural sciences.
Professional Reference articles are designed for health professionals to use. You may find one of our health articles more useful. NICE has issued rapid update guidelines in relation to many of these. This guidance is changing frequently. Assessment of gynaecological problems should be handled with sensitivity and preservation of dignity for the patient. Allow the patient to tell you her problem.
Taking a history is the initial step in the physician—patient encounter. This provides a basis for emphasizing aspects of the subsequent physical examination, and for initial decisions about diagnostic testing and treatment. This chapter outlines the components of a basic gynecologic history and gynecologic examination. Because a discussion of reproductive issues may be difficult for some women, it is important to obtain the history in a relaxed and private setting. The patient should be clothed, particularly if she is meeting the provider for the first time. Ordinarily, the patient should be interviewed alone. Exceptions may be made for children, adolescents, and mentally impaired women, or if the patient specifically requests the presence of a caretaker, friend, or family member.
It can be a delicate subject for some women, and it is important to treat any information divulged with sensitivity and respect. However, the clinician cannot shy away from asking clinically relevant questions. In an emergency scenario, a focused history may be more appropriate. First, use open questioning to allow the patient to fully elaborate on their presenting problem. Ask about impact on their daily life, and how it is currently being managed.
Written and peer-reviewed by physicians—but use at your own risk. Read our disclaimer. See the medical history and physical examination articles for more information on general clinical examination. Obstetric history taking varies based on the setting normal prenatal checkup vs.
И тогда он стал искать иные возможности. Так начал обретать форму второй план. Стратмор вдруг увидел шанс выиграть на двух фронтах сразу, осуществить две мечты, а не одну.
Он заправил рубашку в брюки и оглянулся. Позади уже закрывались двери. Беккер понял, что, если его преследователь находится внутри, он в западне.
Моя смена от семи до семи, - кивнула женщина. - Тогда вы наверняка ее видели. Это совсем молоденькая девушка.
Он по-прежнему показывал время, превышающее пятнадцать часов.
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